Wednesday, March 21, 2012

Resources for Medical Research – We’re Gonna Need a Bigger Boat

By Margaret Anderson, Executive Director, FasterCures

It’s appropriations season in Washington, DC, and we are having an early spring. Why does that make me think of Jaws (the movie)? Because I love the beach and sometimes have nagging anxiety about what swims beneath me when I swim in the ocean? Perhaps. (And yes, I know that sharks attack rarely and they are minding their own business.) More so because I think we have allowed ourselves to forget what the real issue is out there lurking in the water. Resources and the future.

Yesterday, the House Appropriations subcommittee on labor, health and human services, and education chaired by Rep. Denny Rehberg (R-Mont.) convened a distinguished panel that focused on investments at the National Institutes of Health (NIH) and the newly created National Center for Advancing Translational Sciences (NCATS). A lot of the discussion centered on NCATS’ value proposition. And some discussion was about the pros and cons of the NCATS approach. (Let’s remember that NCATS is exactly 2 and a half months old now.)

NIH Director Francis Collins reiterated that NIH support for basic research remains consistent and strong at about 54 percent of the agency’s budget. He said he does not expect that percentage to change. He also emphasized that 98 percent the $575 million funding for NCATS comes from preexisting NIH programs. “We believe we could do a lot with modest resources at this point simply by putting the focus on bottlenecks in the drug development pipeline,” said Collins. Threading the needle? That sounds pretty rational.

Acting NCATS Director Thomas Insel has emphasized that NCATS was created to “complement—not compete with—the private sector.” NCATS pools together existing NIH resources and capacity in translational research to foster greater efficiency. It does not develop drugs; instead, it streamlines and improves processes to increase the odds of getting to therapies faster.

Todd Sherer, CEO of Michael J. Fox Foundation for Parkinson’s Research (MJFF), also providing testimony, noted that in pursuit of a Parkinson's cure, MJFF has funded more than $285 million in research since inception, of which 90 percent has gone straight to translational research. "Based on my experience of what can happen when substantive investments are made in translation, the total contributions NCATS can make to drug development may well be greater than the sum of the parts," he said.

At FasterCures, we support NIH’s efforts to create NCATS. Solutions can be tough to develop, and tougher to implement. Groups like MJFF and other outcomes-driven medical research foundations that are part of our TRAIN network, have demonstrated that innovative approaches to disease research are critical to speeding the R&D process. We must try new, promising avenues. NCATS is one tangible way to get moving. So what about the bigger picture?

We should not forget the larger menace on the horizon, the one that should cause the famousJohn Williams tune from Jaws to be playing in your head now. And that is the need to continue to keep our eye on the overall NIH budget, and the implications of flat or negative funding for NIH, as well as the threat of sequestration in January 2013.

NCATS, new and important as it is, only accounts for a very thin slice of the NIH budget. Our national investment at the 27 institutes and centers at the NIH have yielded great scientific discoveries that have and will continue to improve health.

NIH also plays an essential role in sustaining our economy. A report released yesterday by United for Medical Research found that in 2011, the NIH directly and indirectly supported 432,094 jobs around the country. While significant, this is actually 55,000 fewer jobs than in 2010 – which, according to the report, “demonstrates that the lack of sustained investment in the agency is beginning to have an impact.”

The ripple effects of a constrained NIH budget go far and wide. Should sequestration (mandatory budget cuts should Congress not reach a budget agreement) happen, the NIH will lose 7.8 percent of its budget – $2.5 billion. Collins said that this means that “2,300 grants we had planned to give in fiscal year 2013 would not be able to be awarded. It would be devastating.”

Do we need to keep innovating our research system? Of course, but we also need resources. Resources feed that important basic science part of the continuum. Resources keep our young investigators in the field.

As the appropriations season unfolds, we urge all members of Congress and the medical research community to keep our eyes on the prize: a strong NIH will not only protect and sustain nearly half a million high quality jobs. This agency is also our biggest chance of having more “shots on goal” in the search for treatments and cures.

This is about resources. This is also about patients – patients today and tomorrow. This is also about the future. Let’s get our priorities straight. There are big fish – maybe even some really big ones – out there we need to be focused on, and as Roy Scheider who played Amity Police Chief Brody told us in Jaws, “We’re gonna need a bigger boat.”